{
  "abstract": "Background Central Nervous System (CNS) Lymphoma is an infamously aggressive disease that often presents a diagnostic challenge, frequently resulting in misdiagnosis and delays to appropriate treatment. The gold standard for diagnosis is tissue biopsy. The prognosis is universally poor, with a median prognosis without treatment of 3 months, extending up to 15 months even with systemic treatment. 1 Case We present a highly unusual case of a 51-year-old female with multiple presentations with focal neurological dysfunction over a 15-month period. After an initial non-diagnostic brain biopsy of a solitary right basal ganglia lesion, there was a prolonged indolent period of 13 months with nil new clinical or radiological findings despite lack of treatment. This interval was followed by sudden onset of rapid neurological deterioration with emergence of multiple new radiological lesions, which led to a second brain biopsy that was diagnostic of CNS lymphoma and commencement of treatment.Conclusion This case’s initial extended static period is extremely atypical for a notoriously rapidly progressive disease, and it appears that similar cases have not been reported in the literature, making this case potentially unique. In addition, the case highlights the importance of pursuing repeat biopsy where there is a high degree of clinical and radiological suspicion for CNS lymphoma. Accurate and early diagnosis is critical for institution of appropriate systemic treatment, with the aim to reduce neurological disability and alter prognosis of disease.Reference Roschewski M, Hodson DJ. Diffuse large B-cell lymphoma involving the central nervous system: biologic rationale for targeted therapy. Haematologica. 2024;109(2).",
  "authors": [
    {
      "affiliations": [
        "Royal Adelaide Hospital, Adelaide, SA, Australia"
      ],
      "name": "Imogen Sellars"
    },
    {
      "affiliations": [
        "Royal Adelaide Hospital, Adelaide, SA, Australia"
      ],
      "name": "Joe Lu"
    },
    {
      "affiliations": [
        "Royal Adelaide Hospital, Adelaide, SA, Australia"
      ],
      "name": "Michelle Kiley"
    }
  ],
  "title": "3487 An unusual case of central nervous system lymphoma presenting a diagnostic dilemma",
  "uid": "d60d5074-0c06-534d-b962-c5fbb198baef"
}